Convergence insufficiency (CI) is a common condition that can impair visual performance and comfort during close visual work. This prospective study evaluated the effectiveness of interventions on clinical outcomes and quality-of-life using the adult strabismus quality-of-life questionnaire (AS20) in patients with CI.

Data was extracted from a database collected at first consultation from 2015 to 2022. Demographics, interventions and outcomes of 84 patients with CI (mean age 47.0±24.9 years) were analysed.

Orthoptic exercises were prescribed to 56% of patients, 32% received prisms, 15% received no treatment, with 3 discharged on the same day. At latest follow-up review, 22.6% were recommended to continue exercises, 28.6% had prisms, 1 underwent bimedial resection and 2 had botox. The median follow-up was 5.5(5.0-55)months, 88.1% were discharged with 29.8% following failure to attend and 9.5% deceased. Near-point of convergence (NPC) improved from a median of 15(6-50)cm to 10(6-30)cm. The median AS20 score at presentation were 100(30-100) and 47.5(0-100), and post-intervention were 100(80-100) and 77.5(12.5-97.5) for psychosocial and functional components, respectively.

At the latest follow-up, the attendance failure rate was higher for exercises (36%) than for prisms (15%). Improvement was noted in NPC (33%) and mean AS20 scores was 9% higher psychosocially and 32.8% functionally, highlighting the benefits of intervention on patients’ quality-of-life.

This cohort provides valuable insights into the clinical management of CI, as evidenced by improvements in NPC and AS20 scores. However, the study also found that long-term compliance with treatment is intrinsically challenging, emphasising the importance of disease education.